Patients with chronic hepatitis C infection who are viremic at the time of liver transplantation will have universal recurrence of the virus in the allograft. Long-term survival after transplantation in patients with chronic hepatitis C is diminished as compared with patients who undergo liver transplantation for other indications. The progression of HCV-related fibrosis and the development of cirrhosis appear to be accelerated in the presence of immunosuppression, compared with an immune-competent population. The primary aim of hepatitis C treatment in patients with recurrent hepatitis C infection in the allograft remains eradication of the virus to prevent the progression of liver disease. However, decisions regarding the timing, duration, and optimization of the treatment regimen must be tailored to the individual.
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